Conclusion

Through their initial steps to explore moving the State of Maine to an SBM, Maine officials have demonstrated a commitment to improving the accessibility and affordability of private health insurance. Building and running an SBM is a technical and operational undertaking that presents Maine officials with the unique opportunity to tailor the marketplace to the needs of Mainers and advance the State’s goals around health care and coverage. Informed by interviews with a diverse set of stakeholders and secondary research, this report identifies and recommends policy options for Maine officials as they consider transitioning to an SBM. Broadly, we highlight the need to: 1) increase consumer assistance capacity, 2) integrate consumer engagement into the process of designing and implementing Maine’s SBM, and 3) re-establish the Maine Office of Health Equity to coordinate equity efforts across DHHS.

In topic-specific recommendations, we draw on the experiences of other SBMs and on stakeholder input to identify opportunities that could improve access to affordable and quality health insurance in Maine’s health care context. These topics include enrollment periods, plan display, auto-renewal, and integration with MaineCare. We close our recommendations by examining how the State can leverage an SBM to take advantage of future policy opportunities under a new federal administration.

We would be remiss if we did not mention the tremendous challenges ahead for state budgets generally, as the nation recovers from the staggering loss of life and accompanying economic downturn caused by the coronavirus pandemic. However, the COVID-19 crisis has also further highlighted the importance of ensuring every Mainer can access affordable health insurance and ultimately the care and resources necessary to live a healthy life. We believe our recommendations can help Maine officials make progress towards this important goal and look forward to following future developments.